// Validate the lead form, then send data
	function ValidateForm()	{
		var isFormValid = 1;
		var errorMessage = '';
		var firstName = document.getElementById('FirstName');
		var lastName = document.getElementById('LastName');
		var emailAddress = document.getElementById('EmailAddress');
		var homePhone = document.getElementById('HomePhone');
		
		if(firstName.value.length < 1) 
		{
			isFormValid = 0;
			errorMessage = errorMessage + '- First Name is required.\n';
		}
		if(lastName.value.length < 1) 
		{
			isFormValid = 0;
			errorMessage = errorMessage + '- Last Name is required.\n';
		}
		if(emailAddress.value.length < 1) 
		{
			isFormValid = 0;
			errorMessage = errorMessage + '- Email Address is required.\n';
		}
		if(homePhone.value.length < 1) 
		{
			isFormValid = 0;
			errorMessage = errorMessage + '- Phone Number is required.\n';
		}
		if(IsEmailValid(emailAddress.value) == false)
		{
			isFormValid = 0;
			errorMessage = errorMessage + '- Email Address is not valid.\n';
		}
		if(State.value == '-1')
		{
			isFormValid = 0;
			errorMessage = errorMessage + '- Select a State from the drop down.\n';
		}
		
		if(isFormValid == 0)
		{
			alert(errorMessage);
		}
		else
		{
			window.location = 'http://www.aftermarketsites.com/DataStream-TEST2.aspx?FirstName=' + escape(firstName.value) + '&LastName=' + escape(lastName.value) + '&HomePhone=' + escape(homePhone.value) + '&emailAddress=' + escape(emailAddress.value) + '&ContactTime=' + escape(ContactTime.options[ContactTime.selectedIndex].value) + '&State=' + escape(State.options[State.selectedIndex].value) + '&TotalDebt=' + escape(TotalDebt.options[TotalDebt.selectedIndex].value) + '&ReferURL=' + escape(document.referrer);;
		}
	}
	
	function IsEmailValid(emailAddress) {
		var emailReg = "^[\\w-_\.]*[\\w-_\.]\@[\\w]\.+[\\w]+[\\w]$";
		var regex = new RegExp(emailReg);
		return regex.test(emailAddress);
	}

document.write('<div align="center"><table border="0" cellpadding="0" cellspacing="0">');
document.write('<tr><td valign="top" height="80"></td><td valign="top"></td>');
document.write('<td valign="top"></td></tr><tr><td valign="top">');
document.write('<table border="0" cellpadding="0" cellspacing="0">');
document.write('<tr><td class="arial">First Name</td><td align="center" width="10" class="arial">:</td>');
document.write('<td><input name="FirstName" id="FirstName" type="text" style="width:90px;" maxlength=25 tabindex=1></td>');
document.write('</tr><tr><td height="10"></td><td align="center"></td><td></td></tr>');
document.write('<tr><td class="arial">Email</td><td align="center" class="arial">:</td>');
document.write('<td><input name="EmailAddress" id="EmailAddress" type="text" style="width:90px;" maxlength=50 tabindex=3></td>');
document.write('</tr><tr><td height="10"></td><td align="center"></td><td></td>');
document.write('</tr><tr><td class="arial">State</td><td align="center" class="arial">:</td><td>');
document.write('<select name="State" id="State" tabindex=5>');
document.write('<option selected=true value="-1">Select a State</option>');
document.write('<option value="al">Alabama</option>');
document.write('<option value="ak">Alaska</option>');
document.write('<option value="az">Arizona</option>');
document.write('<option value="ar">Arkansas</option>');
document.write('<option value="ca">California</option>');
document.write('<option value="co">Colorado</option>');
document.write('<option value="ct">Connecticut</option>');
document.write('<option value="de">Delaware</option>');
document.write('<option value="dc">DC</option>');
document.write('<option value="fl">Florida</option>');
document.write('<option value="ga">Georgia</option>');
document.write('<option value="hi">Hawaii</option>');
document.write('<option value="id">Idaho</option>');
document.write('<option value="il">Illinois</option>');
document.write('<option value="in">Indiana</option>');
document.write('<option value="ia">Iowa</option>');
document.write('<option value="ks">Kansas</option>');
document.write('<option value="ky">Kentucky</option>');
document.write('<option value="la">Louisiana</option>');
document.write('<option value="me">Maine</option>');
document.write('<option value="md">Maryland</option>');
document.write('<option value="ma">Massachusetts</option>');
document.write('<option value="mi">Michigan</option>');
document.write('<option value="fm">Micronesia</option>');
document.write('<option value="mn">Minnesota</option>');
document.write('<option value="ms">Mississippi</option>');
document.write('<option value="mo">Missouri</option>');
document.write('<option value="mt">Montana</option>');
document.write('<option value="ne">Nebraska</option>');
document.write('<option value="nv">Nevada</option>');
document.write('<option value="nh">New Hampshire</option>');
document.write('<option value="nj">New Jersey</option>');
document.write('<option value="nm">New Mexico</option>');
document.write('<option value="ny">New York</option>');
document.write('<option value="nf">Newfoundland</option>');
document.write('<option value="nc">North Carolina</option>');
document.write('<option value="nd">North Dakota</option>');
document.write('<option value="oh">Ohio</option>');
document.write('<option value="ok">Oklahoma</option>');
document.write('<option value="or">Oregon</option>');
document.write('<option value="pa">Pennsylvania</option>');
document.write('<option value="ri">Rhode Island</option>');
document.write('<option value="sc">South Carolina</option>');
document.write('<option value="sd">South Dakota</option>');
document.write('<option value="tn">Tennessee</option>');
document.write('<option value="tx">Texas</option>');
document.write('<option value="ut">Utah</option>');
document.write('<option value="vt">Vermont</option>');
document.write('<option value="va">Virginia</option>');
document.write('<option value="wa">Washington</option>');
document.write('<option value="wi">Wisconsin</option>');
document.write('<option value="wv">West Virginia</option>');
document.write('<option value="wy">Wyoming</option>');
document.write('</select>');
document.write('</td></tr><tr><td height="10"></td><td align="center"></td>');
document.write('<td></td></tr><tr><td valign="top" class="arial">Total<br>');
document.write('Unsecured<br>Debt</td>');
document.write('<td align="center" valign="top" class="arial">:</td>');
document.write('<td valign="top">');
document.write('<select name="TotalDebt" id="TotalDebt" tabindex=7>');
document.write('<option value="2000-5000">$2,000-$5,000</option>');
document.write('<option value="5001-10000">$5,001-$10,000</option>');
document.write('<option selected value="10000-20000">$10,001-$20,000</option>');
document.write('<option value="20000-50000">$20,000-$50,000</option>');
document.write('<option value="Over 50000">Over $50,000</option>');
document.write('</select>');
document.write('</td></tr></table></td>');
document.write('<td valign="top"><img border="0" src="images/spacer.gif" width="10" height="1" alt=""></td>');
document.write('<td valign="top"><table border="0" cellpadding="0" cellspacing="0">');
document.write('<tr><td class="arial">Last Name</td>');
document.write('<td align="center" width="10" class="arial">:</td>');
document.write('<td><input name="LastName" id="LastName" type="text" style="width:90px;" maxlength=30 tabindex=2></td>');
document.write('</tr><tr><td height="10"></td><td align="center"></td><td></td>');
document.write('</tr><tr><td class="arial">Phone</td>');
document.write('<td align="center" width="10" class="arial">:</td>');
document.write('<td><input name="HomePhone" id="HomePhone" type="text" style="width:90px;" maxlength=50 tabindex=4></td>');
document.write('</tr><tr><td height="10"></td><td align="center"></td><td></td>');
document.write('</tr><tr><td valign="top" class="arial">Best time<br>');
document.write('to Contact</td>');
document.write('<td align="center" width="10" valign="top" class="arial">:</td>');
document.write('<td valign="top">');
document.write('<select name="ContactTime" id="ContactTime" style="font:8pt Arial;" tabindex=6>');
document.write('<option value="Morning">Morning</option>');
document.write('<option selected value="Afternoon">Afternoon</option>');
document.write('<option value="Evening">Evening</option>');
document.write('</select>');
document.write('</td></tr><tr><td valign="top" class="arial" height="35"></td>');
document.write('<td align="center" width="10" valign="top" class="arial"></td>');
document.write('<td valign="top"></td>');
document.write('</tr><tr>');
document.write('<td valign="bottom" class="arial" colspan="3" align="right">');
document.write('<a href="#"><input name="SubmitButton" id="SubmitButton" type="image" onClick="return ValidateForm();" value="submit" class="no-border" src="images/spacer.gif" width="140" height="35"></a></td>');
document.write('</tr></table></td></tr></table></div></td><td>');
document.write('<a href="/DebtConsolidationBenefits.aspx"><IMG border="0" SRC="images/ConsolidationBenefits.jpg" alt=""></a>');
document.write('</td></tr><tr><td colspan=2 height="35"><img src="images/DebtCall.jpg" alt="">');
document.write('<div align="center"><table border="0" cellpadding="0" cellspacing="0" width="98%">');
document.write('<tr><td><img border="0" src="images/left.jpg" width="11" height="21" alt=""></td>');
document.write('<td width="100%" class="tile"><img SRC="images/NonProfit.jpg" alt="" width=276 height=12></td>');
document.write('<td><img border="0" src="images/right.jpg" width="11" height="21" alt=""></td>');
document.write('</tr></table></div></td></tr></table>');